Topic: Bone Mets Thread

Forum: Stage IV/Metastatic Breast Cancer ONLY — Please respect that this forum is for members with stage IV/metastatic breast cancer ONLY. There is a separate forum for caregivers and friends: Caring for Someone with Stage IV or Mets.

Posted on: Jun 22, 2012 01:09AM - edited Oct 28, 2021 12:22PM by moderators

Posted on: Jun 22, 2012 01:09AM - edited Oct 28, 2021 12:22PM by moderators

Jac53 wrote:

I've started this thread after suggestions that it would be useful.

Mod Note: We have removed the original link as it is no longer viable. At one of our member's' recommendation we are offering this link as a resource for you.

https://youtu.be/YpFfLrITfEI


Jeannie. "You only live once, but if you do it right, once is enough." Dx 6/19/1995, 10/15 nodes Dx 2/18/2011, Stage IV, mets, ER+/PR+, HER2- Dx 7/2/2012, Stage IV, mets, ER+/PR+, HER2-
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May 16, 2022 08:33AM lgp1111 wrote:

Hello all,

I have (for now) a single bone lesion in my left sacrum, which causes mild, occasional discomfort. I've been on Letrozole/Ibrance for several months and had two scans indicating the lesion is stable. My oncologist referred me to a radiation oncologist, who said SBRT was an option. However, in her professional opinion, there is a lack of overwhelming evidence in favor of SBRT. The message I got was: It might slow it down, it might not. Also, there are risks of fracture, nerve damage, etc. My question is: If you were offered SBRT, did you go forward with it? And are you glad you did? Did you have any complications?

Thanks so much for sharing your personal experience.

Dx 12/22/2013, IDC, Right, 4cm, Stage IIIA, Grade 2, 4/10 nodes, ER+/PR+, HER2- Surgery 1/2/2014 Lumpectomy; Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel Surgery 2/2/2014 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Reconstruction (Right): Tissue Expander Chemotherapy 2/24/2014 AC + T (Taxol) Radiation Therapy 7/7/2014 Breast, Lymph nodes Hormonal Therapy 8/17/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/15/2014 Surgery 4/1/2015 Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Fat grafting, Silicone implant Hormonal Therapy 10/1/2021 Femara (letrozole) Targeted Therapy 10/1/2021 Ibrance (palbociclib) Dx 10/6/2021, IDC, Other, Stage IV, metastasized to bone, Grade 2, ER+/PR-, HER2- Radiation Therapy 5/23/2022 Other part Targeted Therapy 10/1/2022 Kisqali
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May 16, 2022 08:51AM sondraf wrote:

I did - they just did my L4 (which was the only lesion growing at the time) and threw in the L3 "for free" as part of the mapping which wasn't causing problems but could in the future. Two years ago my L5 and nasty sacral met,which WAS causing big problems, were also done.

The benefit of radiating lesions that may be not currently growing is that it can lower the overall tumor burden and possibly stop issues before they happen between scans. My L4 met grew very quick out of a "stable" scan and I had no pain. Rather than waiting for a drug to deal with it, it was better to get it done and out of the way.

We have a number of ladies on here who have solitary mets they zapped and continue to be clean as a whistle years down the line on I/L. It may cause fracture, but if it were me I would take that chance for one met. I mean, it can fracture without radiation too, think of it that way. Ive never had any nerve damage, though obviously we are all different as to size and location of mets. I did have mild gastro issues with the sacral radiation, but just for a day or two.

"The closer we come to the negative, to death, the more we blossom" - Montgomery Clift Dx 9/27/2019, IDC, Right, 5cm, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- Hormonal Therapy 11/28/2019 Femara (letrozole) Targeted Therapy 11/28/2019 Ibrance (palbociclib) Surgery 11/28/2021 Lymph node removal (Right): Underarm/Axillary; Mastectomy (Right) Targeted Therapy 3/1/2022 Lynparza (olaparib)
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May 16, 2022 11:20AM cowgal wrote:

lgp1111 - I was not a candidate for SBRT because my bone lesion was too large (over 7 cm). However, I did get a targeted radiation to my lone bone met and it was more intense then the chest wall radiation I had received for my lower stage cancer in 2010. The RO did a more targeted/intense radiation plan then she would have normally given because of the possibility of me being an oligmetastatic and seeing this as an opportunity to get the cancer before it went somewhere else. Mine was in my collarbone. The RO should be able to tell you what possible risks you could get from radiation in that area. I lost a bit of arm mobility in my shoulder. I might have been able to get some of that back with PT done earlier but it happened right at the start of the COVID pandemic. I am glad I did it as the next scan done a couple of months after I completed radiation showed that I was NEAD! I have been NEAD since July 2020 (getting ready to go over recent scans this week with my MO and praying to GOD that I continue at that status. I am on Ibrance/Faslodex/XGEVA.

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May 16, 2022 02:57PM olma61 wrote:

I had numerous bone mets and became NED after my first six months of Taxol, H&P. Then the met in my spine at L1 woke up and my MO referred me to an RO. Insurance would not cover SBRT but EBRT was possible so we did it. I have been NED ever since. The EBRT was three years ago this month. I had no complications of any kind from the radiation. My RO told me, because I asked, that the met that was radiated would be less likely to become active again after being zapped

10/30/2017 Xgeva for bone mets 5/31/2018 Taxol finished! "If one just keeps on walking, everything will be all right” - Kierkegaard Dx 8/3/2017, IDC, Right, 2cm, Stage IV, metastasized to bone, Grade 2, ER+/PR+, HER2+, IHC Targeted Therapy 10/28/2017 Perjeta (pertuzumab) Targeted Therapy 10/28/2017 Herceptin (trastuzumab) Chemotherapy 10/29/2017 Taxol (paclitaxel) Hormonal Therapy 5/14/2018 Arimidex (anastrozole) Radiation Therapy 5/29/2019 External Local Metastases 5/29/2019 Radiation therapy: Bone
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May 16, 2022 04:50PM lgp1111 wrote:

Thank you so much @olma61 @cowgal @sondraf

That is very helpful. I really appreciate it. Sondra, you are so right -- it could fracture without radiation. I needed that reminder. Thanks again everyone.

Dx 12/22/2013, IDC, Right, 4cm, Stage IIIA, Grade 2, 4/10 nodes, ER+/PR+, HER2- Surgery 1/2/2014 Lumpectomy; Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel Surgery 2/2/2014 Lymph node removal; Lymph node removal (Right): Underarm/Axillary; Mastectomy; Mastectomy (Right); Reconstruction (Right): Tissue Expander Chemotherapy 2/24/2014 AC + T (Taxol) Radiation Therapy 7/7/2014 Breast, Lymph nodes Hormonal Therapy 8/17/2014 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Surgery 10/15/2014 Surgery 4/1/2015 Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Silicone implant; Reconstruction (Right): Fat grafting, Silicone implant Hormonal Therapy 10/1/2021 Femara (letrozole) Targeted Therapy 10/1/2021 Ibrance (palbociclib) Dx 10/6/2021, IDC, Other, Stage IV, metastasized to bone, Grade 2, ER+/PR-, HER2- Radiation Therapy 5/23/2022 Other part Targeted Therapy 10/1/2022 Kisqali
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May 16, 2022 05:41PM star2017 wrote:

I had hip/sacrum/femur mets. I only asked about SBRT for the femur, and while they considered it, they decided the fact that it's weight bearing, SBRT is not a good option. Every met we're aware of has been radiated. The smaller (sacrum, femur) mets are no longer active. The larger hip met has very low-level decreasing activity (there's a small fracture there too that may be causing activity in the scans).

The sacrum radiation hasn't bothered me really at all. The combo of cancer and radiation to the hip and femur have led to stiffness (being in early menopause doesn't help!), but it's all manageable as long as I keep moving.

CURRENT: Stage IV since 2020, bone mets to rt hip, sacrum, femur, all treated with radiation. Taking Lynparza daily. Dx 9/2017, DCIS/IDC, Right, 6cm+, Stage IIIA, Grade 3, 4/8 nodes, ER+/PR+, HER2- Surgery 10/16/2017 Mastectomy; Mastectomy (Right); Reconstruction (Right): Tissue Expander Chemotherapy 11/28/2017 AC + T (Taxol) Surgery 4/17/2018 Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Silicone implant Radiation Therapy 5/21/2018 Whole breast: Breast, Lymph nodes Surgery 10/24/2018 Reconstruction (Left): Silicone implant Hormonal Therapy 6/18/2019 Arimidex (anastrozole) Dx 5/2021, IDC, Right, 6cm+, Stage IV, metastasized to bone, ER+/PR+, HER2- Targeted Therapy Verzenio Radiation Therapy External Hormonal Therapy Faslodex (fulvestrant) Local Metastases Radiation therapy: Bone
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May 17, 2022 12:11AM - edited May 17, 2022 12:17AM by sondraf

I think especially to the sacrum - its so weight bearing down there and more difficult to "shore up" like a femur or a hip or even a vertebrae where they can throw in some hardware, replace completely, or stuff in some cement. And what you don't want to happen is to end up in a situation where you are in a lot of pain and then cannot walk or move comfortably to exercise. Get ahead of it before it gets ahead of you!

"The closer we come to the negative, to death, the more we blossom" - Montgomery Clift Dx 9/27/2019, IDC, Right, 5cm, Stage IV, metastasized to bone, Grade 3, ER+/PR+, HER2- Hormonal Therapy 11/28/2019 Femara (letrozole) Targeted Therapy 11/28/2019 Ibrance (palbociclib) Surgery 11/28/2021 Lymph node removal (Right): Underarm/Axillary; Mastectomy (Right) Targeted Therapy 3/1/2022 Lynparza (olaparib)
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May 17, 2022 06:28AM - edited May 17, 2022 06:39AM by perky2020

I had radiation 2ce while on I/F. The first time was targeted to the hip joint (acetabulum). I got another year out of I/F. The next was SBRT to the iliac crest. But I continued to progress in other areas so I moved to AA.

I wasn't aware there was controversy over SBRT? I was thinking it was just the new and improved version? It was so much easier, really a non-event except that i had to go in fot treatment.

Star2017 - did they say why SBRT was not good for a weight bearing joint?

Dx 2/6/2015, IDC, Left, 2cm, Stage IIA, Grade 2, 0/3 nodes, ER+/PR-, HER2- Surgery 3/16/2015 Lymph node removal; Mastectomy; Mastectomy (Left); Reconstruction (Left) Chemotherapy 5/26/2015 Cytoxan (cyclophosphamide), Taxotere (docetaxel) Hormonal Therapy 9/30/2015 Arimidex (anastrozole) Hormonal Therapy 11/1/2016 Aromasin (exemestane) Dx 12/27/2016, IDC, Stage IV, metastasized to bone, ER+/PR-, HER2- Hormonal Therapy 1/2/2017 Faslodex (fulvestrant) Targeted Therapy 1/11/2017 Ibrance (palbociclib) Radiation Therapy 1/14/2017 External Local Metastases 1/14/2017 Radiation therapy: Bone Radiation Therapy 4/13/2020 Other part Radiation Therapy 5/16/2021 Other part Targeted Therapy 10/1/2021 Afinitor (everolimus) Hormonal Therapy 10/4/2021 Aromasin (exemestane) Hormonal Therapy 4/1/2022 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone)
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May 17, 2022 08:38AM sadiesservant wrote:

I think I’ve commented on my radiation treatments recently but will circle back given the conversation. I’ve had five separate treatments for bone met related pain since being diagnosed as metastatic in late 2016. It’s hard to remember the order of treatments now but I believe the first treatment was due to sudden onset of severe sciatica after progression on Arimidex. It was ridiculous in that I could barely stand in the morning, going to the bathroom was an adventure. One zap of the lumbar spine took care of the issue. Then, despite everything appearing to be stable, I later needed a zap to my right hip (I was having trouble walking) and then my sacrum. I have extensive bone mets which seem to progress slightly in spots.

I next had an issue with numbness and tingling in my right arm/hand. MRI didn’t show progression but I was having some facial numbness and, for the first time, they flagged skull mets and mets to my cervical spine. Apparently this is unusual (although I have certainly heard from many here who have skull mets) so they don’t typically scan for them - bone scans are useless for me so they didn’t show up. We took a wait and see approach given potential complications but about a year later I started getting severe headaches. Five sessions of rads to the base of my skull and upper c-spine resolved the issue. Now, last week, I finished five sessions to my c-spine/thoracic spine as a new lesion was impinging the nerves causing significant right shoulder pain and numbness of my right arm. I’m still recovering with no signs of improvement yet but I think there is quite a bit of inflammation from the treatment, despite the steroids. It can take several weeks to see results so I am trying to be patient, hoping there isn’t any permanent nerve damage.

I’ve never had SBRT. My understanding from my RO is that it would not have been appropriate in my case as it is very high intensity with the potential to cause significant collateral damage in delicate areas like the spine. Instead my RO chose a more targeted beam delivered over multiple sessions.

Wish me luck on recovery. I’m desperate to get off of the steroids - so sleep deprived! (And tired of the nasty taste. Yuck!) I tried to taper back but had to increase the dose again as the numbness was getting worse and there was a bit of breakthrough pain. I may try to dial it back again on Thursday. Here’s hoping.

Dx 4/2001, IDC, Right, 1cm, Stage IIA, Grade 3, 1/10 nodes, ER+ Surgery 5/10/2001 Lumpectomy; Lumpectomy (Right); Lymph node removal; Lymph node removal (Right): Sentinel, Underarm/Axillary Chemotherapy 6/7/2001 CEF Radiation Therapy 12/17/2001 Whole breast: Breast Hormonal Therapy 12/20/2001 Tamoxifen pills (Nolvadex, Apo-Tamox, Tamofen, Tamone) Hormonal Therapy 1/2/2007 Femara (letrozole) Hormonal Therapy 10/21/2007 Arimidex (anastrozole) Dx 1/3/2017, IDC, Right, Stage IV, metastasized to bone/lungs, ER+/PR+, HER2- Chemotherapy 1/27/2017 Taxol (paclitaxel) Hormonal Therapy 3/28/2017 Arimidex (anastrozole) Targeted Therapy 4/19/2017 Ibrance (palbociclib) Dx 10/12/2017, IDC, Right, Stage IV, metastasized to other Chemotherapy 10/20/2017 Xeloda (capecitabine) Radiation Therapy 11/15/2017 External Local Metastases 11/15/2017 Radiation therapy: Bone Hormonal Therapy 1/18/2018 Faslodex (fulvestrant) Radiation Therapy 8/2/2018 External Local Metastases 8/2/2018 Radiation therapy: Bone Radiation Therapy 11/5/2018 External Local Metastases 11/5/2018 Radiation therapy: Bone Targeted Therapy 10/9/2019 Verzenio Radiation Therapy 11/3/2020 External Local Metastases 11/3/2020 Radiation therapy: Bone Dx 1/22/2021, IDC, Right, 1cm, Stage IV, metastasized to liver, Grade 2, ER+/PR+, HER2- Chemotherapy 2/4/2021 Xeloda (capecitabine) Chemotherapy 10/8/2021 Other Chemotherapy 1/7/2022 Other
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May 17, 2022 06:16PM star2017 wrote:

perky2020, the issue with my femur met is that it grew right on the edge of my last radiation field, so I think the combo of it being weigh-bearing and potentially weakened by past radiation led them to decide that traditional radiation would be best. In the Pet scan that followed there was no activity on that site any more.

CURRENT: Stage IV since 2020, bone mets to rt hip, sacrum, femur, all treated with radiation. Taking Lynparza daily. Dx 9/2017, DCIS/IDC, Right, 6cm+, Stage IIIA, Grade 3, 4/8 nodes, ER+/PR+, HER2- Surgery 10/16/2017 Mastectomy; Mastectomy (Right); Reconstruction (Right): Tissue Expander Chemotherapy 11/28/2017 AC + T (Taxol) Surgery 4/17/2018 Prophylactic mastectomy; Prophylactic mastectomy (Left); Reconstruction (Left): Tissue Expander; Reconstruction (Right): Silicone implant Radiation Therapy 5/21/2018 Whole breast: Breast, Lymph nodes Surgery 10/24/2018 Reconstruction (Left): Silicone implant Hormonal Therapy 6/18/2019 Arimidex (anastrozole) Dx 5/2021, IDC, Right, 6cm+, Stage IV, metastasized to bone, ER+/PR+, HER2- Targeted Therapy Verzenio Radiation Therapy External Hormonal Therapy Faslodex (fulvestrant) Local Metastases Radiation therapy: Bone

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